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June 28, 2012

Supremes uphold Obamacare

The Supreme Court on Thursday let stand President Obama’s health care overhaul, in a mixed ruling that court observers were rushing to analyze.

The decision was a striking victory for the president and Congressional Democrats, with a majority of the court, including the conservative chief justice, John G. Roberts Jr., affirming the central legislative pillar of Mr. Obama’s term.

The justices voted 5 to 4 to uphold the law's individual mandate provision and thus the entire law, as authorized by Congress' power to levy taxes.

Many observers called the case the most significant before the court since at least the 2000 Bush v. Gore ruling, which decided a presidential election. In addition to the political reverberations, the case helps set the rules for one of the largest and fastest-growing sectors of the economy, one that affects nearly everyone from cradle to grave.

The decision did significantly restrict one major portion of the law: the expansion of Medicaid, the government health-insurance program for low-income and sick people. The ruling gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for.

The debate over health care remains far from over, with Republicans vowing to carry on their fight against the law, which they see as an unaffordable infringement on the rights of individuals. The presumptive Republican presidential nominee, Mitt Romney, has promised to undo it if elected.

But the court ruling is a crucial victory for the law that will allow its introduction to continue in the coming years. Passed in 2010, the law is intended to end the United States’ status as the only rich country with large numbers of uninsured people, by expanding both the private market and Medicaid.

The key provision that 26 states opposing the law had challenged – known as the individual mandate – requires virtually all citizens to buy health insurance meeting minimum federal standards or to pay a fine if they refuse.

Many conservatives considered the mandate unconstitutional, arguing that if the federal government could compel people to buy health insurance, it could compel them to buy almost anything, with broccoli becoming the central example in court arguments.

The mandate’s advocates said it was necessary to ensure that not only sick people but also healthy individuals would sign up for coverage, keeping insurance premiums more affordable. The law offers subsidies to poorer and middle-class households, varying with their incomes. It also provides subsidies to some businesses for insuring their workers.

The law requires states to expand Medicaid coverage for poor and nearly poor households. In all, tens of millions of people are expected to gain insurance from the law, according to the Congressional Budget Office, as part of a march toward universal coverage, a goal that has eluded legislators and presidents – including Franklin Delano Roosevelt, Harry S. Truman, Lyndon B. Johnson, Richard M. Nixon and Bill Clinton – for generations.

The decision came on the last day of the term, which the justices extended by three days to deal with the crush of major issues. On Monday, the court delivered a mixed ruling on an Arizona law intended to crack down on illegal immigrants, which the Obama administration opposed.

Under Chief Justice Roberts, the court has delivered a series of major victories to conservatives, including the Citizens United campaign finance decision, which on Monday it declined to reconsider. In next year’s term, it could take up other major issues, including affirmative action, same-sex marriage and the Voting Rights Act.

The health care ruling came three months after an extraordinary series of oral arguments in which the differences on the bench, if not the ultimate outcome, were disclosed in sharp relief.

Until those arguments, many observers – within the White House and beyond – had seen the law as likely to survive a legal challenge that even many Republicans once viewed as a long shot. But the skeptical questioning of a majority of the justices – and Justice Kennedy in particular – called that view seriously into doubt.

Rulings by appeals courts had split on the question, with two upholding the law and one striking down the mandate. A fourth appeals court deferred consideration of the law until 2015, reasoning that the courts lacked jurisdiction until the first penalties enforcing the mandate became due.

Although there were some exceptions, in the lower courts most judges appointed by Democrats voted to uphold the law, while most appointed by Republicans voted to reject at least part of it."

Some news organizations were obviously sure about a different outcome, and initially rushed to broadcast their prediction. This misinformation was broadcast over several networks and corrections had to be made--10 minutes later~

Comments

Sweeeet Cheeezus, the GOP is having kittens over the Supreme Court ruling on the Affordable Care Act. Speaker Boehner is turning multiple shades of orange, like a radioactive chameleon. And Mitch "Snapping Turtle" McConnell has rolled over onto his shell, unable to get up off the floor, his reptilian flippers flailing. Rush Limbaugh's waddle has exploded, spilling his stash of Oxycontin across the room, and Bill O'Reilly is curled up in the fetal position in a cheap hotel room, nervously chewing on his loofah. It's gonna be a great day.

The right wing is in full, hysterical meltdown. Can't wait to read Scalia's dissent. Just remember: health insurance companies are people, too, my friend, and you're not, so their right to murder you trumps your right to stay alive.

Hadn't realized that Breyer and Kagan both voted against the medicaid legislation. Kagan voted against her own President? Has that every happened on the right? In the first year?

Oh my gosh! Paul Campos of Salon just aaid that Roberts was under enormous pressure to maintain the healthcare law. His decision came in at the very last minute which is why some CNN and others got wrong at first. Wow!

Oh my gosh a second time you guys! Campos just expounded on his claim that Roberts was last minute on Cenk's show. He said that the minority opinion was clearly the majority opinion at one time meaning that Roberts defected at the last minute.

Also, did you see that Jamie Dimond is wrong again? It wasn't two billion but nine billion! He should be gone!

Cenk is better than O'Donnell. O'Donnell pontificates too much. Cenk gets great conversation going and they always provide new insights into the topics. He's great!

interesting that mike d uses the word hate when it is more likely that people disagree. while some may 'hate' --much like the bush derangement syndrome-- exists with some many others may just plain old disagree.

but mike d makes a good point in that roughly speaking at any one time among the folks that will vote you got 40ish percent who will vote for Pres Obama and 40ish percent that will vote for Gov Romney. It is that remaining 20ish percent and more important, what swing states this 20ish percent lives that will make all the difference.

Watch the Electoral College Map. Right now it is working against Gov Romney.

Yes, a tactic of he and others of the left persuasion is to bring in their hate to the conversation and then say that conservatives hate something - which is typically ad hominem. This tactic is called projection. T-S uses that tactic on a regular basis, like when she points the name calling finger at you or I, while she has already done it herself.

Matthews, O'Donnell and Sgt.Schultz are the masters in projection that the resident "grasshoppers" have learned from.

Keeping it honest by blowing the whistle on projection is a big chore in these politically charged days. Whenever I do it, I should be called on it, but not falsely.

Well, I see the great censor has been cutting posts again. I'd like to know how giving KS politics 101 on how Roberts kept his conservative reputation by giving the right another tax talking point was "not nice."

So, I'll retreat and give the blog back over to PS and KS. They're such fun to read.

you are a guest on this blog. you don't pay the bills or moderate it. this is something that all of us need to keep in mind.
hum-so-ever, feel free to start your own blog. i would be very very interested in reading it.

I know most people have caught Jean Schmidt's premature mean-gasm, but only 19 seconds of the footage is being broadcast in most places. The following link is the 47 second video. The camera pans away from her so you don’t see her “Wait what?” moment, but you can hear her exclaiming ‘only congress can make it a tax!’

Thom Hartmann just made a very good point about how this decision will be the "Roe v Wade" of this generation. It, like RvW will continually be a target for overturning, even generations from now.

He also made the point that if you are really for personal responsibility, you should approve of the mandate. No longer will the rest of us have to pay for those who choose not to have coverage (typically young people who think they are invincible) and then get in an accident or develop a serious disease. Also, there is no enforcement built into the bill to collect the fine/tax so the rumor of people going to jail is false. As is the statement that those of us who are lucky enough to have health insurance will now lose what we have.

Thank you Chief Justice Roberts. Can you believe how nasty the right wing is towards you? And Fox news, getting it completely wrong. They just proved to the world that they are not fair and balanced, just hateful and bigoted. Thank you again Chief Justice Roberts as you have saved millions of future lives and bankruptcies that has been the norm under the right wing nuts.

Hartmann seemed to have confused accepting personal responsibility and acceptance of a nanny state.

There are some aspects of the ACA that are popular, such as those under 26 insured by their parents and pre-existing conditions. Contrary to what Harry Reid, Nazi Pelosi or Chucky Schumer say; the Republicans have a plan to replace some the numerous less popular aspects of the ACA with less costly and more efficient measures, but also to retain the two popular aspects I mentioned above. The marketplace, unlike the Government will help drive down the costs.

Before you go spouting off with progressive talking points without knowing what you are talking about, check what Rep. Tom Price and other Republicans in the House have proposed. I will surprise you if you can keep an open mind that long.

I read them, KS and they put people at risk. Still divides us into haves and have nots.
Sorry, that isn't acceptable to me.

I hope a loved one of yours never has to go through what my Mom did with her stage 4 Lymphoma. Because of her health insurance, she was able to get the best of care and is now cancer free. I assume YOU have insurance? Then Obamacare wont affect you unless you lose your job and then you will continue to be covered in case something happens to you or loved ones.

Yes, I have health ins. Can you be specific as to how the Republican alternatives put people at risk ? Which plans have you read ? There are several - the latest by Rep. Paul Brown, GA. The additional 25+ million non-insured should have coverage that is affordable and the Republicans have included this coverage in their plans, but by the way it is being portrayed in the media - the uninsured are being thrown over the cliff - hope you have taken the time to acknowledge the merits of the other side.

One good part of the ACA that I didn't mention is that it may limit ER's and control the costs that way and there needs to be a cheaper alternative than COBRA plans for those who lose their jobs. If they haven't already - don't know, the GOP need to get their arms around that aspect or work across the aisle to adopt something more acceptable.

Fortunately your mother was able to get the treatment she needed and is well now.

Paul Broun? He wants vouchers instead of Medicare. Hand a senior citizen $8000 and wish them luck?
That will go over quite well with the AARP crowd. He also wants to privatize it. Private companies (like insurance companies) can then decide who gets treatment (just like insurance companies. That does nothing to insure the millions who don't have health insurance. It doesn't change anything or help anyone.
With luck, you will get old, too, KS. Unless you have a couple of million stashed away so you can pay all of your medical costs associated with aging, you will rely on Medicare. With Obamacare you wont be told no by an insurance company because you might have had an illness in your past. You will still be able to pick your doctor and your hospital. The women in your life won't be discriminated against anymore and charged more for their insurance. The insurance companies are already being forced to spend the bulk of your premiums on actual CARE instead of red tape and big salaries. They won't be able to reward their workers based on the percentage of applicants to whom they deny life-saving care.
Maybe it's because my career has been spent helping people on a one on one basis that prevents me from accepting anything that causes more suffering. Im not saying you dont care about people, but the system sure doesnt and I will never give up on working to make it better.

Before you throw block grants to the states and vouchers over the cliff - have you read any studies on them and results of how they actually work ? I reserve judgment until I see definitive evidence that they are inadequate - there may be some additional percs that we don't know about. There are also other plans that may be different, like by Tom Price - former doctor Rep. GA.

"With Obamacare you wont be told no by an insurance company because you might have had an illness in your past. You will still be able to pick your doctor and your hospital. "

Not entirely true. The GOP plans intend to keep existing conditions in their replacement. I am fairly certain of that. Still able to pick your doctor and hospital - I give you that unless the doctor opts out, but not necessarily your health insurance as over 20 million people have lost theirs and had to find another carrier since Obamacare was implemented. I don't see why the GOP plan(s) would be any different.

I remember when he said that you can keep the same insurance as you had before back in 2009, which 20 million + folks found to be untrue. He also denied that the individual mandate was a tax and still does today for purely political reasons, while the SCOTUS did not strike down the mandate because they thought of it as a tax. How does one (not necessarily you) explain that ?

"If my mom had had to rely on vouchers, she wouldn't be here today. Hopefully nothing like that will happen to any of your relatives or friends."

Posted by: sparky | June 29, 2012 at 05:17 PM

Instead of making that blanket statement, wouldn't that depend on how much the vouchers were for - I'd guess that the cost may have run above $30,000.

Her treatment was over $300,000..surgeries, blood transfusions, long term chemo, dr. visits, the shot on Sunday mornings that prevented nausea after a week of chemo cost $4000--per shot. She has her primary care with Medicare and her supplimental which she pays for. It is an 80%-%20 deal. A $30K voucher would not have come close.

Where did you hear that 20million lost their health care directly because of Obamacare?

You mean their insurance, not their health care ? This was recently publicized again. There's a difference there. They eventually had to find other insurance carriers to return to getting health care.

"he said that you can keep the same insurance as you had before back in 2009, which 20 million + folks found to be untrue? "

The cost of $30K was just a very rough guess. In her case, she would nave needed $60K with the 80-20 split if $300K was the total. Are you sure that none of the alternative plans does not support cases like that ? That doesn't sound right, although. Obamacare may not allow that either, as their failure to sufficiently bend the cost curve will lead to rationing as numerous studies have suggested. However, the current healthcare system worked for your mother - hmmm....

Determining that would take a fair amount of research. You may have check some conservative websites to find that answer.

Single payer is cheaper and results in more rationing in Canada Why are so many Canadians coming over here for significant surgeries then ? It works for simple treatments but the waiting lists are so long for significant surgeries, like Sparky's mothers' situation that they get the treatment way sooner here than in Canada.

japan has socialized medicine. but from personal experience i can tell you that when you get to be a certain age certain procedures that you could get here are unavailable to you. moreover, instead of sharing a room with just one or two fellow patients you'll share it 6 or more.
and coiler, if canada was so good why folks coming here to get treated?
not a challenge, just a question.

i'll look forward to reading about this in T-S's upcoming blog. i'm sure she'll be providing a link at some point.

I looked up an old email my friend Rosemary sent me..Rose teaches in BC. She got this from an article she read in the paper, but I can't tell you which one because she didnt say.

Myth: Canada's government decides who gets health care and when they get it.
While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.
There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.
Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

sparky
she may have gotten from the Randi Rhodes Message Board as that is where I read it. awhile ago.

14 months for a knee replacement. i do wonder how well the surgery went. That sounds like a long time but it takes awhile to get treatment. Ater all, when a member of the Canadian Parliament, a Ms Stronach, who was received her initial cancer therapy in Canada, but then came to the U.S. (UCLA) for surgery, which was unavailable in Canada. Ms. Hackett assures us that "Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is."
Well, that's interesting. I guess that Doctor shortage is just another one of those Canadian Myths.

If I didn't see President Obama's constituents getting all those waivers I would feel more comfortable about what was coming down the pike.

I will say this: the individual mandate is a necessary part to make this work. Younger folks will hate it, but it is the only way to make the single payer system feasible.

KVI am 570 KHz Visit the burnt-out husk of one of the seminal right-wing talkers in all the land. Here's where once trilled the reactionary tones of Rush Limbaugh, John Carlson, Kirby Wilbur, Mike Siegel, Peter Weissbach, Floyd Brown, Dinky Donkey, and Bryan Suits.
Now it's Top 40 hits from the '60's & '70's aimed at that diminishing crowd who still remembers them and can still hear.

KTTH am 770 KHzRight wing home of local, and a whole bunch of syndicated righties such as Glennn Beck, Rush Limbaugh, Michael Medved, Sean Hannity, Laura Ingraham, Lars Larsony, and for an hour a day: live & local David Boze.